Increased Incidence of Perforated Appendixes in Hmong Children in California

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Abstract
Health care for Hmong immigrants from Southeast Asia to the United States has been associated with major social, cultural, and communication problems.1 To determine whether the health care received by Hmong patients differs from that received by other patients, I studied the incidence of appendiceal perforation among 118 Hmong children and an equal number of randomly selected white children who underwent primary appendectomy between January 1989 and December 1997. The research was conducted at Valley Children's Hospital in Fresno, California. The hospital serves central California, where many of the 120,000 Hmong immigrants in the United States live. The research was part of fieldwork conducted in central California between September 1996 and August 1998; it was supported by grants from the Agency for Health Care Policy and Research, the National Science Foundation, and Valley Children's Hospital.2